European Journal of Molecular & Clinical Medicine

Intubation and maintenance of the patient’s airway is one of the most important steps in anaesthesia practice and a fundamental responsibility of the anaesthesiologist. Difficult intubation has been associated with serious complications particularly when failed intubation results.
Materials and Methods: This study will be conducted in Department of Anaesthesiology at Tertiary Hospital, Bangalore. It is multispecialty hospital having all specialties with very good number of case load. Hospital have highly equipped Anaesthesiology department. The study will include 300 Adult patients posted for elective surgical procedures under General Anaesthesia.
Results: Three hundred apparently normal ASA grade 1&2 adult patients in the age group 18 - 60yrs of either sex posted for elective surgical procedures were prospectively studied.
DISCUSSION: In earlier days anaesthesia was induced by anaesthestic vapours given
through face mask. Due to inability to maintain a patent airway, adequate depth of anaesthesia for surgical procedures and its complication leading to morbidity and mortality led to development of safer anaesthetic practice by maintaining anaesthesia through endotracheal insufflation.
Conclusion: The present study has shown that the combination of modified Mallampatti test and thyromental distance is better than when used alone in predicting difficult intubation

Background: Difficult airway is a condition in which a trained anaesthesiologist has
trouble with complications. Risk factors associated with difficult airway are failure or delay
identifying at risk patients and poor planning. Objectives: To study predictors of difficult
airway intubation in patients undergoing general anaesthesia.
Materials & Methods:Single centre, prospective observational study in which patients
scheduled for surgery were included. In addition to patient’s demographic information,
indication for surgery, modified Mallampati grading, inter incisor distance, neck
circumference was noted. Patients were monitored intraoperatively.
Results: Mean Age was 35.9 ± 14.2 years, majority were of ASA status I (65.5%). Mean
sternomental distance was 15.1 ± 2.1 cm, mean thyromental distance was 6.1 ± 1.1 cm &
ratio of height to thyromental distance (RHTMD) was 23.1 ± 5.1. Mallampati class 3/4 in
supine position were 28.25%, class 3/4 sitting were 19.25%, other significant features were
short muscular neck (10.5%), neck movement <80˚ (4%), inter incisor distance ≤3.5 cm
(4%) & limited mandibular protrusion (2.25 %). Difficult intubation was noted in 8%.
Significant factors associated with difficult intubation were Mallampati class 3/4 (sitting),
increased sternomental distance, increased thyromental distance, increased ratio of height
to thyromental distance (RHTMD), short neck, snoring history, neck movement <80˚, short
inter‑ incisor distance, cervical spondylosis & limited mandibular protrusion.
Conclusion: Significant factors associated with difficult intubation were Mallampati class
3/4 (sitting), more sternomental distance, more thyromental distance, increased ratio of
height to thyromental distance (RHTMD), short neck, snoring history, neck movement
<80˚, inter‑ incisor distance ≤3.5 cm, cervical spondylosis & limited mandibular
protrusion. Predicting difficult intubation during the preoperative assessment is a key
challenge, as no single clinical predictor is sufficiently valid for predicting the outcomes.